Individual provider Active NPI

Jessica R Otis, FNP

  • Family Nurse Practitioner
  • Bath, NY
National Provider Identifier
1255004727
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
347851 Issued in NY
Practice address
7573 State Route 54
Bath, NY 14810-9504
Phone
(607) 776-2247
NPI assigned
Jul 29, 2021
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 347851 NY Primary
Family Medicine Physician 207Q00000X 347851 NY

Addresses

Primary practice location

7573 State Route 54
Bath, NY 14810-9504

Mailing address

7573 State Route 54
Bath, NY 14810-9504
Phone (607) 776-2247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220215002258 NY Practitioner - Nurse Practitioner 4183017148 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arnot Medical Services PLLCGroup PAC ID 0840450748, 91 clinicians

Practice addresses (Care Compare)

226 W Morris St
Bath, NY 14810-1413
Phone (607) 776-8700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.03 of 100Reported as group
Quality
100
Improvement activities
40
Cost
86.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
347851NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arnot Medical Services PLLC Family Medicine CurrentSince May 4, 2025 Accepting new patients
Keuka Family Practice Associates LLP Family Medicine CurrentSince Mar 30, 2022 Accepting new patients

Locations

226 W Morris St
Bath, NY 14810
Phone (607) 776-8700

7573 State Route 54
Bath, NY 14810
Phone (607) 776-2247

571 Saint Josephs Blvd
Ste 304
Elmira, NY 14901
Phone (607) 271-2050

600 Ivy St
Ste 206
Elmira, NY 14905
Phone (607) 271-2050

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1255004727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7573 STATE ROUTE 54",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148109504",
            "telephone_number": "607-776-2247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7573 STATE ROUTE 54",
            "city": "BATH",
            "state": "NY",
            "postal_code": "148109504",
            "telephone_number": "607-776-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIS",
        "first_name": "JESSICA",
        "middle_name": "R",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "347851",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "347851",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bath, NY

Sources for this page

Verify at the official NPI Registry.